Time marches on until one morning you wake up with a stiff, sore joint. Ouch! Where did that come from? Maybe that skiing injury thirty years ago is sneaking back to take a bite out of your comfort level. Maybe the years of kneeling to clean floors, lay tile, or catch baseballs are taking a toll. At some point, you have to ask yourself one question: “How can I prevent further deterioration of my joints?” The answer is simpler than you may realize.

First, you have to RESPECT your body. Respect the fact that you are getting older. In this aging process, the body loses its ability to bounce back. Recovery times are longer and the tissues can only tolerate so much, now that you are older. Activities that you once did when you were younger may not be appropriate for you now or at least not that often. Respecting your boundaries, limitations, and physical condition is the first very important step towards preventing joint problems and preserving what you have.

The second step to prevent further deterioration of your joints is to HELP your body. You can help your body in so many different ways from what you wear to what you eat. For example, if you are worried about your knees, then you should be choosing proper shoe wear that is supportive and well-cushioned. At times, you may want to consider an assistive device like a walking stick to reduce the stress and strain on your knees. You can also help your joints by eating a nutritious low glycemic load diet which can help control joint inflammation and improve your joint healing potential. Every day you should be thinking of ways to help your body from the minute you get out of bed to the time you go to sleep. Take charge of how you feel and help yourself.

As time marches on, preparing your joints for the future should be a matter of respecting your body and helping your body. Just by following those two simple rules, joints can live a happy, healthy, and full life. Like it or not, time does not stop and the person with the most joint replacements does not win.

All who tried them loved ‘em and have begged for the recipe. Here it is, a healthy way to start the day with whole grains, tofu, and fruit.

Blueberry Almond Bar
1 cup soft tofu
½ cup canola oil
1 cup Honey
½ cup sugar (optional)
¼ cup soy milk or almond milk
1 TBSP vanilla extract
1 TBSP almond extract (optional)
1 large egg
2 large egg whites

Combined all wet ingredients into a blender and blend well together.

1 cup Kashi Heart to Heart Blueberry and Oat Flake Cereal
1 cup Kashi GOLEAN Crunch Honey Almond Flax Cereal
1 cup Stone ground Whole Wheat flour
2 tsp baking powder
¼ tsp salt
½ Dried Blueberries and/or Cherries

Crush dry ingredients together and add to the wet mixture. Mix together. Pour mixture which will be thin into a lightly greased 9×13 pan. Sprinkle on topping of:
½ cup of sliced almonds
½ cup Kashi Heart to Heart Blueberry and Oat Flake
½ cup GOLEAN Crunch!

Bake in 350o oven for 20 to 25 minutes until done or until toothpick comes out clean. Cut and enjoy.

Never underestimate the power of a comfortable night’s sleep. Tossing and turning all night, waking up in pain, the worst pain is in the morning; if any of this sounds familiar, you may need a new mattress. I have seen countless numbers of people with these same complaints. When I ask about the mattress, a majority of the time the answer is the same, “Well, my mattress is pretty old”. How old? Ten years? Twenty years? Thirty years? Come on people, mattresses wear out and new technology becomes available. Recently, a new patient came to see me with a mysterious pain that only occurs at night while in bed. Well, wouldn’t you know it; her bed was a waterbed nearly as old as I am. Come on! Mystery solved. A crappy bed will cause pain.

Think about it. Everyone is very concerned about posture while sitting, working, and playing. What about sleep posture? You spend half of your life sleeping, right? Sleep posture depends on a well made sleep foundation that supports your alignment while relieving pressure points. Imagine sleeping with your spine bent or twisted all night. With such poor sleep posture, pain will happen no matter how healthy your spine is. Spend ten or twenty years with a habitually poor sleep posture, permanent changes will occur like stretched ligaments and joint arthritis. A good mattress is an investment towards continued spine health.

Now is not the time to get cheap. A new mattress is an investment in you. Which one should you invest in? Hands down, the best mattress on the current market is the Tempur-Pedic Cloud Supreme. You might have heard of “Cloud 9”. Well the Tempur-Pedic company has just perfected “Cloud 10”. How do I know? Well, I bought one. After laying on it for the first time at Foothill Mattress Company, I was immediately sold, no questions asked. Some may know that I have been sleeping on an original “classic” Tempur-Pedic mattress with a Tempur-Pedic foundation. Well this “Cloud Supreme” is far superior to the old “classic” technology. The new technology called Tempur-ES took years to develop and perfect. This new material is truly supportive, yet not too firm. All of my pressure points are relieved, my sleep posture is supported and I am no longer waking up in pain. Hooray! I am sleeping on Cloud 10.

After two weeks on our new mattress, my husband and I can report that we sleep more soundly. We wake up feeling rested. And most importantly, I am no longer experiencing a mysterious pain in the middle of the night. So, if too you have pain that wakes you up, try sleeping on the new Tempur-Pedic Cloud Supreme (a.k.a Cloud 10). Doctor’s Orders!

Life can be a pain in the neck. The number of people with neck pain must have skyrocketed when the computer was invented. Just look at the way you are sitting at your computer right now. Is your head careened forward like a turtle? Are your shoulders rounded forward? Is your mid-back slouched like a “C” shaped curve? This posture sustained for a period of time can lead to neck pain or a pain between the shoulder blades. What can you do to save yourself from a pain in the neck?

1. Invest in a good pillow: Especially for those folks who sleep on their sides, a supportive, thick pillow can keep the head from reaching for the pillow. If the head reaches for the pillow because the pillow does not fill the gap between the tip of the shoulder and the ear, then the neck spends all night misaligned. That’s when you will wake up with a pain in the neck.

2. Stretch the Pec’s: Those big muscles under your breasts are called the Pectoralis muscles. Over time, these muscles shorten because everything you do is in front of you and the arms rarely reach behind the back. Well, you need to reach behind the back once and a while to rebalance these shoulder muscles and realign the neck.

3. Avoid heavy weight on the top of the shoulders: Heavy purses, backpacks, bras, and suspenders; all of these heavy weights pull the shoulders down and overload the sensitive neck muscles. Find alternatives; try to be smarter than the neck pain by unloading the purse, finding a backpack with rollers, trying a camisole, or giving up the suspenders. Stop dragging your neck down.

4. Keep your chin tucked: The chin really should not drift more than 5 finger breadths away from the chest. As the chin drifts upwards, the back of the neck starts to pinch. Those sensitive joints and nerves in the neck will cry out in pain if the chin is held too high, too long.

5. Keep the chest out: You may not be in the military, but the shoulders back, chest out posture is ideal for proper neck alignment. Rounded shoulders with a caved-in chest lead to an abnormally arched posture (increased lordosis). Use a mirror to guide you as you try to save your neck. Overtime, with proper diligence, a good posture can relieve neck pain.

You might have noticed that I have mentioned the shoulders quite a few times in this discussion about saving your neck. Because the shoulders provide the base of support for your neck, shoulder posture and activity heavily influences the neck mechanics. Ninety percent of the time, neck pain is easily predicted just by looking at a person’s shoulders. This leads our conversation back to the observation of your posture as you sit at your computer. As you sit at your computer typing and clicking, check your shoulders often because they will drift forward before you can say “Neck Pain”. The shoulders should rest behind the hallow of your neck where the collar bone connects to the chest bone. Check with a professional if you are not sure where to rest your shoulders. Body posture awareness is not as easy as it sounds, but worth the trouble to learn. Your neck is worth some extra effort. And with these tips, you can save yourself from a pain in the neck.

Anyone been to Costco lately? If you go, look for a wonderful whole grain called farro in a small bag. When I was recently there, one of the promoters/preparers was making farro for customers to try in the isle. This grain is worth a try and here is a fabulous summer salad recipe using farro. Great for gatherings.

It keeps well for days especially if you omit the arugula and serve the wheat salad over a bed of arugula at mealtime.

Don’t forget to try my Quinoa recipe. Remember, good nutrition can help you control pain. Both Quinoa and farro are members of the anti-inflammatory diet.

Wheat Salad with Vegetables and Mint Vinaigrette
(by Joyce Goldstein)
For cooking the farro
Water 3 cups
Salt pinch
Farro* 1 cup

Farro is an early winter wheat that is organic and usually from Italy. If unable to find farro, may substitute with barley.

For the salad

Olive Oil 2 TBSP
Mint Vinaigrette (see recipe to follow)
Salt to taste
Black Pepper to taste
Red Onion ½ cup, chopped
Celery ½ cup, chopped
Cucumber 1 cup, peeled, seeded, and chopped
Sm. Tomatoes 4 ea, chopped
Arugula 3 cups, chopped leaves
Flat parsley ¼ cup, chopped
Fresh Mint ¼ cup, chopped

Method

1) To cook the farro, bring the water to boil and salt it lightly. Add the farro, reduce the heat to low, cover, and simmer. Check for doneness after 20 minutes. When cooked, the grain will be tender but still have some firmness at the center. Drain any remaining water.
2) Place the drained farro in a bowl, toss with the olive oil and let it cool (preferably overnight).
3) When cool, toss farro with half the dressing. Fold in the onion, celery, cucumber, tomatoes, parsley, and mint. Add remaining dressing and toss again.
4) Taste and adjust seasoning. Enjoy.

Mint Vinaigrette

For infusion

Fresh lemon juice ¼ cup
Fresh Mint leaves ¼ cup chopped

For vinaigrette

Mild Olive Oil 1 ¼ cup
Red Wine Vinegar ¼ cup
Fresh lemon juice 2 TBSP
Fresh Mint ½ cup
Honey 1 tsp
Salt ½ tsp
Directions

1) For the infusion, combine lemon juice and chopped mint in a small saucepan. Bring to a boil and remove from heat. Let steep for 10 minutes. Strain through colander into a mixing bowl, pressing to extract all the liquid. There will be about ¼ cup of liquid.
2) Add remaining ingredients into mixing bowl with infused liquid. Whisk thoroughly.

Not a pain in the rear, a pain in the neck, or a pain in the back, you have a pain between the shoulder blades. Like a knife in the back, this pain can be stabbing or searing. Like a muscle cramp, this pain can be aching or gripping. This pain can feel like many things, yet there are only a few common causes of a pain between the shoulder blades. And all these problems have one common root: the shoulder girdle muscles.

Sometimes, the pain around the shoulder blades actually comes from the complex system of muscles that stabilize the shoulder called the “shoulder girdle” muscles. Two primary muscles in this system are very prone to weakness, overuse and strain: the rhomboid and the trapezius muscles. Just by looking at the position at which the shoulder blade rests, called the scapular start position, a professional can actually see the effects of a weakened shoulder girdle. A typical abnormal start position is drooping (depressed) shoulder blades which tend to spread apart (abducted). When the shoulder blades are held in this sagging position, the trapezius and rhomboid muscles are stretched to the limit and are virtually incapable of holding up the weight of the arm against the constant pull of gravity. Like anchors, the arms constantly pull on sensitive neck muscles and nerves. As the body weight increases, so does the weight of the arms. Eventually, the whole system fails. And shoulder girdle failure leads to all types of pains around the neck, down the arm, and between the shoulder blades. Preventing such pain problem is a good reason to maintain core strength and an ideal body weight.

Core strength can also help to prevent referred neck pain, another primary cause of pain between the shoulder blades. If the shoulder blades are not resting in the proper position then that means the shoulders and the neck are also in a misaligned position. One typical abnormal posture is called the forward shoulder/head posture. As the shoulders drift forward (in front of the collar bone), the head drifts forward like a turtle peeking out from his shell. I call this the “turtle posture” in my book, High Heels to Hormones: A Woman’s Guide to Spine Care. This “turtle” posture places stress on many cervical spine structures like the discs, ligaments, and joints. All of these parts of the neck can cause referred pain between the shoulder blades. (Referred pain means that the pain is felt one place but is generated in another; like the pain from a heart attack can be felt in the arm.) Preventing this referred pain can be as easy as keeping the shoulders back, the chest out, and the core muscles strong.

Good posture can also help to prevent thoracic spine stiffness and misalignment, another cause of pain between the shoulder blades. The area of the spine that lies between the shoulder blades is called the upper thoracic spine. Because ribs also attach to the spine in this area, the upper thoracic spine is prone to stiffness and boney misalignment. A misaligned rib might need adjustment. A stiff thoracic segment might need mobilizing. Boney adjustments by a manual therapist or chiropractor could be just what the doctor ordered for some types of pain between the shoulder blades. However, without good muscle tone in the shoulder girdle, boney posture and alignment cannot be maintained.

In fact, all of the common reasons to have a pain between the shoulder blades lead back to one ultimate root: muscle weakness. Muscles are what keep the shoulders moving properly. Muscles are what support the shoulder blades as they glide across the chest wall. Muscles are what hold the arms up against the constant pull of gravity. If it feels like there is a knife between your shoulder blades, it might be time to tone some important muscles—the shoulder girdle muscles.

The hip, the hip; no wait, it is the Greater Trochanter. Anytime someone says that he/she has “hip” pain I always question where exactly she/he is talking about. Nine times out of ten the area of pain is not the actual hip joint, but rather the Greater Trochanter.
The Greater Trochanter is at the top of the femur, on the side (see Picture, the green pen is pointing to the Greater Trochanter). The actual hip joint lies deep within the pelvis, near the pubic bone (see picture, the pink pen is pointing to the hip joint). Distinguishing between the two areas of potential pain is very important to arrive at the correct diagnosis and treatment plan.

Why would the Greater Trochanter become painful? I can think of six reasons: 1) Quadratus Femoris 2) Gluteus Medius 3) Piriformis 4) Gluteus Minimus 5) Obturator Internus 6) Obturator Externus. These six muscles all attach to the Greater Trochanter and these insertion points can become inflamed and painful (called tendonitis). Another reason that the area of the Greater Trochanter can become painful is called bursitis. A bursa allows freedom of movement and cushioning for the tendon as it passes over a bone. This bursa can also become inflamed and painful—bursitis. Greater Trochanter pain is not a sign of hip joint arthritis because the hip joint is in a totally separate area. For this reason, Greater Trochanter pain is treated differently than hip joint pain.

Thus ends the anatomy lesson.

Drugs in the Water Systems

Some tasks should be done once per year like spring house cleaning or closet cleaning. Reorganizing and regrouping the clutter that accumulates over the year is necessary to avoiding a heap of chaos. The same can be said for the medicine cabinet. Medicines accumulate over time and that can lead to a potentially dangerous situation; the more bottles, the more confusion and chance for an unintentional medication accident. Recently, I discovered that an 86 year old patient of mine had amassed a huge amount of expired prescriptions. Plus, she was medicating herself with this supply depending on how she felt. That’s scary.

Opening a medicine cabinet can also be scary. Petrified toothpaste, tangled dental floss, and dust bunnies lie along side drugs that date back to the 90’s, 80’s, and even 70’s. Now is the best time to clean out the medicine cabinet. But here is the dilemma: What do you do with the old drugs? Some people prefer for the convenience and ease of the flushing them. What’s the harm in that, right? Wrong, the Environmental Protection Agency is now charged with monitoring the drugs in the drinking water. That is right; drugs are in the drinking water. Most of these drugs are there not from intentional dumping, but from being excreted in the urine. Still, flushing drugs is not the best way for ridding ourselves of unwanted medications. In fact, the Federal Drug Administration has an official “Flush it” list of approved drugs for flushing, most of which are opioids and benzodiazepines. What about the non-“Flush-It” medications? What do you do with those?

The safest way to discard the drugs is through medication “take-back” programs. Locally, the Grass Valley Police Department has a collection system for drugs. This year, the Waste Management Company will also start a medication collection program. Pharmacies, hospitals, and clinics do not want the prescriptions returned to them. So, if a “take-back” program is not available, the FDA recommends mixing the chemicals in “kitty litter” or “coffee grounds” and put the whole thing in the trash. The whole idea is to keep the drugs out of the wrong hands which can be very small hands indeed.

The whole idea for cleaning out the medicine cabinet is to keep you safe. Besides, who wants a 30 year old bottle of drugs that has been hanging out with dust bunnies.

Is 2010 off to a good start for you? January is the month when many people think about making improvements, changes, and refinements. All of this is in an effort to create something significant, something momentous. Each New Year, each new day presents an opportunity for distilling an earthshaking potion for a better life. What ingredients will you add to your potion this year or today?

Happiness might be a good place to start. You have the right to pursue happiness despite what ails you. Recently, one patient told me about her mission and a website called the Happiness Project. If anyone needs some advice about how to find a bit of paradise in the world, this website is a great place to spark your quest. We should all be In Pursuit of Happiness.

Another ingredient in your world-shattering potion should also be relaxation. Do you start your day in a calm or anxious state of mind? Have you started your year in a calm state of mind? Energy levels not only effect how you feel, but also effect every being around you: children, pets, parents, co-workers, and friends. With four dogs, I can attest that starting the day with calm state of mind helps my pack. We begin each morning with a meditative walk. With each turn around the property in the right, relaxed state of mind, I am one fundamental step closer to having a momentous day. What is your next step into the first turn of 2010?

Ultimately, your day and your year is what you make of it. You will go in the direction that you are looking towards; be it mundane or momentous.

Men, how can you control pain with food? A critical link to feeling better is the inflammation process that can be fueled by what you eat. Learn what an anti-inflammatory diet can do for you by joining Dr. Christina Lasich at In The Kitchen on March 4th, 2010. Sign up by calling Wendy VanWagner at 530-478-0669.

Event Description:
This dinner program is designed with the thought that food can represent a form of medicine and be pleasing to even the manliest man. Dr. Christina Lasich, MD has designed a menu for a small group of MEN ONLY that will emphasize the ways cooking can control pain. Please look for nutritious spins off of these old favorites. Dr. Lasich will discuss topics such as antioxidants, glycemic index versus load, herbal remedies for pain, and full flavor, manly cooking. The cost is $35 per man. The event is on March 4th, 2010 from 6:30 pm to 8:30pm. Please sign up soon because space is limited.

Menu

Chips and Dip

Spaghetti and Meat Sauce

Apple Pie